Sensory Integration: Resource Packet

RESOURCE PACKET:
Sensory Integration
FAMILY & COMMUNITY RESOURCE CENTER

Special School District of St. Louis County
12110 Clayton Road
St. Louis, MO 63131 .
989-8438/989-8108/989-8194/989-8431
314-989-8449 (fax)
314-989-8400 (TTY)
September 2014
Center for the Study of Autism Page 1 of3
Sensory Integration
Cindy Hatch-Rasmussen, M.A., OTRIL
Therapy Northwest, p.e.
Beaverton, OR 97005
Children and adults with autism, as well as those with other developmental disabilities, may have a
dysfunctional sensory system. Sometimes one or more senses are either over- or under-reactive to
stimulation. Such sensory problems may be the underlying reason for such behaviors as rocking,
spinning, and hand-flapping. Although the receptors for the senses are located in the peripheral nervous
system (which includes everything but the brain and spinal cord), it is believed that the problem stems
from neurological dysfunction in the central nervous system--the brain. As described by individuals with
autism, sensory integration techniques, such as pressure-touch can facilitate attention and awareness,
and reduce overall arousal. Temple Grandin, in her descriptive book, Emergence: Labeled Autistic,
relates the distress and relief of her sensory experiences.
Sensory integration is an innate neurobiological process and refers to the integration and interpretation
of sensory stimulation from the environment by the brain. In contrast, sensory integrative dysfunction is
a disorder in which sensory input is not integrated or organized appropriately in the brain and may
produce varying degrees of problems in development, information processing, and behavior. A general
theory of sensory integration and treatment has been developed by Dr. A. Jean Ayres from studies in the
neurosciences and those pertaining to physical development and neuromuscular function. This theory is
presented in this paper.
Sensory integration focuses primarily on three basic senses--tactile, vestibular, and proprioceptive. Their
interconnections start forming before birth and continue to develop as the person matures and interacts
with hislher environment. The three senses are not only interconnected but are also connected with other
systems in the brain. Although these three sensory systems are less familiar than vision and audition,
they are critical to our basic survival. The inter-relationship among these three senses is complex.
Basically, they allow us to experience, interpret, and respond to different stimuli in our environment.
The three sensory systems will be discussed below.
Tactile System: The tactile system. includes nerves under the skin's surface that send information to the
brain. This information includes light touch, pain, temperature, and pressure. These play an important
role in perceiving the environment as well as protective reactions for survival.
Dysfunction in the tactile system can be seen in withdrawing when being touched, refusing to eat certain
'textured' foods and/or to wear certain types of clothing, complaining about having one's hair or face
washed, avoiding getting one's hands dirty (i.e., glue, sand, mud, finger-paint), and using one's finger
tips rather than whole hands to manipulate objects. A dysfunctional tactile system may lead to a
misperception oftouch and/or pain (hyper- or hyposensitive) and may lead to self-imposed isolation,
general irritability, distractibility, and hyperactivity.
Tactile defensiveness is a condition in which an individual is extremely sensitive to light touch.

Theoretically, when the tactile system is immature and working improperly, abnormal neural signals are
sent to the cortex in the brain which can interfere with other brain processes. This, in tum, causes the
brain to be overly stimulated and may lead to excessive brain activity, which can neither be turned off
nor organized. This type of over-stimulation in the brain can make it difficult for an individual to
organize one's behavior and concentrate and may lead to a negative emotional response to touch
sensations.
http://www .autism.org/si.html 6/20/2008

Center for the Study of Autism Page 2 of3
Vestibular System: The vestibular system refers to structures within the inner ear (the semi-circular
canals) that detect movement and changes in the position of the head. For example, the vestibular system
tells you when your head is upright or tilted (even with your eyes closed). Dysfunction within this
system may manifest itself in two different ways. Some children may be hypersensitive to vestibular
stimulation and have fearful reactions to ordinary movement activities (e.g., swings, slides, ramps,
inclines). They may also have trouble learning to climb or descend stairs or hills; and they may be
apprehensive walking or crawling on uneven or unstable surfaces. As a result, they seem fearful in
space. In general, these children appear clumsy. On the other extreme, the child may actively seek very
intense sensory experiences such as excessive body whirling, jumping, and/or spinning. This type of
child demonstrates signs of a hypo-reactive vestibular system; that is, they are trying continuously to sti
mulate their vestibular systems.
Proprioceptive System: The proprioceptive system refers to components of muscles, joints, and tendons
that provide a person with a subconscious awareness of body position. When proprioception is
functioning efficiently, an individual's body position is automatically adjusted in different situations; for
example, the proprioceptive system is responsible for providing the body with the necessary signals to
allow us to sit properly in a chair and to step off a curb smoothly. It also allows us to manipulate objects
, using fine motor movements, such as writing with a pencil, using a spoon to drink soup, and buttoning
one's shirt. Some common signs of proprioceptive dysfunction are clumsiness, a tendency to fall, a lack
of awareness of body position in space, odd body posturing, minimal crawling when young, difficulty
manipulating small objects (buttons, snaps), eating in a sloppy manner, and resistance to new motor
movement activities.
Another dimension of proprioception is praxis or motor planning. This is the ability to plan and execute
different motor tasks. In order for this system to work properly, it must rely on obtaining accurate
information from the sensory systems and then organizing and interpreting this information efficiently
and effectively..,
Implications: In'general, dysfunction within these three systems manifests itself in many ways. A child
may be over- or under-responsive to sensory input; activity level may be either unusually high or
unusually low; a child may be in constant motion or fatigue easily. In addition, some children may
fluctuate between these extremes. Gross and/or fine motor coordination problems are also common
when these three systems are dysfunctional and may result in speech/language delays ,and in academic
under-achievement. Behaviorally, the child may become impUlsive, easily distractible, and show a
general lack of planning. Some children may also have difficulty adjusting to new situations and may
react with frustration, aggression, or withdrawal.
Evaluation and treatment of basic sensory integrative processes is performed by occupational therapists'
and/or physical therapists. The therapist's general goals are: (1) to provide the child with sensory
information which helps organize the central nervous system, (2) to assist the child in inhibiting and/or
modulating sensory information, and (3) to assist the child in processing a more organized response to
sensory stimuli.
For further information, contact: Sensory Integration International, P.O. Box 9013, Torrance, CA 90508,
USA .
The Autism Research Institute distributes an infonnation packet on

physical therapies: sensory integration, exercise, holding.
Click h~r~ to learn how to obtain this packet.
http://www.autism.org/si.html 6/20/2008 2
LD OnLine:: DiMatties Page 1 of5
@nline
Understanding Sensory Integration
By: Marie E. OiMatties (2004)
Michael is a third grade student who is waiting for the school bus. He is challenged by sensory experiences
during everyday activities that most of us don't even think about. While he's still reeling from the battle
with mom over brushing his teeth (that peppermint toothpaste tastes like fire in his mouth) the school bus
pulls up. Michael runs past the bus monitor's haze of perfume and sits at the back of the bus. In his
heightened state, he becomes even more aware of his new school shirt with its stiff label and that awful
feeling like a wire brush being poked into the back of his neck. The sensory experiences of the movement
of the bus, the sound of his excited classmates laughing and yelling above the roar of the bus engine all
contribute to his increased agitation. By the time Michael arrives at school he is wound up and ready to
unravel. There is no time to wait for the bus monitor's direction ... getting off the bus quickly becomes a
matter of survival and he resorts to pushing, shoving and finally kicking his way out. Unfortunately, there is
.a price to pay for this seemingly outward aggression ... he can expect another trip to the principal's office.
This digest defines sensory integration and sensory integration dysfunction (051). It outlines evaluation of
051, treatment approaches and implications for parents and teachers, including compensatory strategies for
minimizing the impact of 051 on a child's life.
What is Sensory Integration?
Sensory Integration is a theory developed more than 20 years ago by A. Jean Ayres, an occupational
therapist with advanced training in neuroscience and educational psychology (Bundy & Murray, 2002).
Ayres (1972) defines sensory integration as "the neurological process that organizes sensation from one's
own body and from the environment and makes it possible to use the body effectively within the
environment" (p. 11). The theory is used to explain the relationship between the brain and behavior and
explains why individuals respond in a certain way to sensory input and how it affects behavior. The five
main senses are:
• Touch - tactile
• Sound - auditory
• Sight - visual
• Taste - gustatory
• Smell - olfactory
In addition, there are two other powerful senses:
a) vestibular (movement and balance sense)-provides information about where the head and body are in
space and in relation to the earth's surface.
b) proprioception (joint/muscle sense)-provides information about where body parts are and what they are
doing.
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LD OnLine:: DiMatties Page 20[5
What is Sensory Integration Dysfunction (DSI)?
Dysfunction in sensory integration is the "inability to modulate, discriminate, coordinate or organize

sensation adaptively" (Lane et ai., 2000, p. 2).
How efficiently we process sensory information affects our ability to:
a) discriminate sensory information to obtain precise information from the body and the environment in
order to physically interact with people and objects. An accurate body scheme is necessary for motor
planning, i.e., being able to plan unfamiliar movements. It involves having the idea of what to do,
sequencing the required movements, and executing the movements in a well-timed, coordinated manner.
Michael frequently bumps into others and drops items on the way to class because of his poor body
. scheme. He often hands in crumpled assignments that reflect the challenges of holding a pencil in his hand
and making precise movements to achieve legible handwriting. Concentrating on his school work intensely
may lead him to fall off his chair. To most people, Michael appears to be a sloppy, clumsy, and forgetful
child.
In gym class, Michael cannot master jumping jacks, somersaults make him feel sick, and he has given up
on ever being able to connect with a baseball. His timing was always off. He resorts to being the class
clown to cover up for his difficulties. Michael certainly doesn't feel good about himself. He can't do what
other kids seem to do so effortlessly-and then there is the teasing ...
b) modulate sensory information to adjust to the circumstances and maintain optimum arousal for the task
at hand. Sensory modulation is the "capacity to regulate and organize the degree, intensity and nature of
responses to sensory input in a graded and adaptive manner" (Miller & Lane, 2000).
Sensory defensiveness, a type of sensory modulation problem, is defined by Wilbarger and Wilbarger
(1991) as "a constellation of symptoms related to aversive or defensive reactions to non-noxious stimuli
across one or more sensory systems" (Wilbarger & Wilbarger, 2002a, p. 335) It can affect changes in the
state of alertness, emotional tone, and stress (Wilbarger & Wilbarger, 2002a).
Michael demonstrates many symptoms of sensory defensiveness, which affect his attention, learning, and
behavior. His teacher's instructions get lost in competition with a clock ticking, the echo of peers walking
and talking in the hall. He is off task and he finds solace in humming or chewing on the end of his pencil,
sensory seeking behaviors that help ease the discomfort. Fortunately, he has gym class before lunch.
Running bases in gym class gives him a legitimate opportunity for the "heavy work" that his body needs. It
sure makes him feel better and prepares him for the biggest challenge of all- eating lunch in the school
cafeteria.
How is 051 identified?
DSI is identified through evaluation by an occupational therapist who has advanced training in sensory
integration, using one or more of the following practices:
• Gathering information about the child's performance in daily life tasks within the context of the
classroom, school, and/or home environment.
• Skilled observation of the child: the therapist sets up a play environment and observes the child's
responses to different types of sensory input and motor planning ability.
• Parent/caregiver sensory questionnaires /standardized checklists, e.g., Sensory Profile (Dunn, 1999),
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non-standardized checklists.
• Parent/caregiver interview: the therapist identifies specific functional problems related to problems
with sensory processing.
• Standardized tests of general development and motor functioning, e.g., Sensory Integration and
Praxis Test Battery (SIPT) (Ayres, 1989).
• Clinical observations of posture, coordination, etc.
Intervention for DSI
Fostering the child's participation in normal everyday childhood activities or "occupations" is the main goal
of occupational therapy. Intervention starts when teachers and parents are taught about DSI and
intervention so they can develop strategies that help with adaptation or compensation for dysfunction
(Bundy & Koomar, 2002). Based on information gathered, the therapist collaborates with teachers and
parents to design an intervention plan to address the child's sensory integration problems.
Intervention based on Sensory Integration Theory
Therapist consultation aims to educate teachers, parents, and older children about sensory integration and
to develop strategies to adapt to and compensate for dysfunction such as:
• environmental modifications
• adaptations to daily routines
• changes in how people interact with the child (Wilbarger & Wilbarger, 2002)
Examples are reducing distracting visual materials in the classroom, giving the child an alternative to a
messy art activity, or refraining from wearing perfume or bright, floral clothing.
A sensory diet is a strategy that consists of a carefully planned practical program of specific sensory
activities that is scheduled according to each child's individual needs. Like a diet designed to meet an
individual's nutritional needs, a sensory diet consists of specific elements designed to meet the child's
sensory integration needs. The sensory diet is based on the notion that controlled sensory input can affect
one's functional abilities (Wilbarger & Wilbarger, 2002b). A sensory diet can help maintain an age
appropriate level of attention for optimal function to reduce sensory defensiveness.
Wilbarger & Wilbarger's (200b) comprehensive approach to treating sensory defensiveness includes
education and awareness, a sensory diet, and other professional treatment techniques. One such technique
is the Wilbarger Protocol, which uses deep pressure to certain parts of the body followed by proprioception
in the form of joint compressions. It is critical that this protocol is not used in isolation and that it is
initiated and monitored by an appropriately trained therapist.
The "How Does Your Engine Run?" Program (Williams & Shellenberger, 1994) is a step-by-step method that
teaches children simple changes to their daily routine (such as a brisk walk, jumping on a trampoline prior
to doing their homework, listening to calming music) that will help them self-regulate or keep their engine
running "just right." Through the use of charts, worksheets, and activities, the child is guided in improving
awareness and using self-regulation strategies.
Traditional sensory integrative therapy
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Traditional sensory integrative therapy takes place on a 1: 1 basis in a room with suspended equipment for
varying movement and sensory experiences. The goal of therapy is not to teach skills, but to follow the
child's lead and artfully select and modify activities according to the child's responses. The activities afford a
variety of opportunities to experience tactile, vestibular, and proprioceptive input in a way that provides the
"just right" challenge for the child to promote increasingly more complex adaptive responses to
environmental challenges. The result is improved performance of skills that relate to life roles, e.g., player,
student, (Schaaf & Anzalone, 2001). This type of intervention may be used along with other treatment
approaches.
Summary
DSI can have a profound effect on a child's participation in everyday childhood "occupations," including
play, study and family activities. Collaboration between the therapist, teacher, and parent is the most
efficient way to understand the child's behavior and unique sensory needs. Together, they can implement
strategies to support the child's performance in roles and occupations across multiple environments.
Sensory Integration Resource Center - provides links to Internet resources and research about Sensory
Integration Dysfunction (DSI) for parents, educators, occupational therapists and physicians. Available:
http://www.sinetwork.org/
The ERIC Clearinghouse on Disabilities and Gifted Education (ERIC EC)
The Council for Exceptional Children
1110 N. Glebe Rd.
Arlington, VA 22201-5704
Toll Free: 1.800.328.0272
E-mail: ericec@cec.sped.org
Internet: http://ericec.org
References
Ayres, A. J. (1972). Sensory integration and learning disorders. Los Angeles: Western Psychological
Services. Ayres, A. J. ( 1989). Sensory integration and praxis tests. Los Angeles: Western Psychological
Services.
Bundy, A. c., Lane, S. J., & Murray, E. A. (2002) Sensory integration: Theory and practice. Philadelphia: F.
A. Davis.
Dunn, W. (1999). Sensory Profile. San Antonio: Psychological Corporation.
Kranowitz, C. S. (1998). The out of sync child. New York: The Berkley Publishing Group.
Lane, S. J., Miller, L. J., & Hanft, B. E. (2000). Towards a consensus in terminology in sensory integration
theory and practice: Part 2: Sensory integration patterns of function and dysfunction. Sensory Integration
Special Interest Section, 23(2), 1-3.
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LD OnLine:: DiMatties Page. 5 of5
Miller, L. J. & Lane, S. J. (2000). Towards a consensus in terminology in sensory integration theory and
practice: Part 1: Taxonomy of Neurophysiological Processes. Sensory Integration Special Interest Section,
23(1),1-4.
Quirk, N. J. & DiMatties, M. E. (1990). The relationship of learning problems and classroom performance to
sensory integration. Haddonfield, NJ: Author. Available: www.amazon.com.
Wilbarger P. & Wilbarger, J. (1991). Sensory defensiveness in children aged 2-12: An intervention guide for
parents and other caregivers. Denver, CO: Avanti Educational Programs.
Williams, M.S., & Shellenberger, S. (1994). How Does Your Engine Run? Albuquerque: Therapy Works.
Sammons, Jennifer H. - The ERIC Clearinghouse on Disabilities and Gifted Education (ERIC EC)- ERIC EC
Digest ED478564 - May 2003
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©2008 WETA. All Rights Reserved.
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Executive Director:
Jane Koomar. Ph.D .• OTRIL. FAOTA
Clinkai Director:
Anne Trecker. MS, OTRlI~
124 Watertown St.

Watertown. MA 02472
Phom!: 617-923-4410
Fax: 617-923·0468
Emaii: info@otawatertown.com
Occupational Therapy Associates _.
VVat61'town, p.e
How do I know if my infant/toddler has sensory

integration dysfunction?
A child may need to be referred for an occupational therapy evaluation if difficulties are seen in
several of these areas or if one area causes major functional problems.
1. Is easily startled
2. Has difficulty consoling self; is unusually fussy

3. Has poor muscle tone
4. Is unable to bring hands together and bang toys
5. Is slow to roll over, creep, sit, or stand
6. Has difficulty babbling
7. Does not explore
8. Cries or becomes tense when moved through space
9. Frequently makes fists (after six months)
_ 10. Has difficulty tolerating a prone (on stomach) position
11. Dislikes baths
_. 12. Has difficulty playing with age-appropriate toys
__ 13. Resists being held or becomes tense when held; dislikes being cuddled
_ 14. Has sucking difficulties
_ 15. Is overly active; seeks excessive movement
_16. Is unable to settle down; has sleep difficulties
For more information please call

Occupational Therapy Associates - Watertown, P.c. at (617) 923-4410.
Exe~utivc Director:
Jane Koomar. Ph.D .• OTRfL. FAOTA
Clinical Dircc,or:
Anne Trecker. MS. OTRfL.
124 Watertown St.

Watertown. MA 02472
Phone: 617·923-4410
Fax: 617-923-0468
Email: info@otawatertown.com
Oc.cupational Therapy Associates -

\'Vatertowr.. P.e.
How do I know if my preschool child (3 to 5 years) has

sensory integration dysfunction?
1. Says III can't" or "I won't" to age-appropriate self-care or play activities

2. Has low muscle tone; seems weak or floppy
3. Is clumsy; falls frequently
4. Bumps into furniture or people; has trouble judging body in relation to space
around him/her
5. Breaks toys or crayons easily
6. Does not enjoy jumping, swinging, or having feet off the ground
7. Dislikes coloring within lines, doing puzzles. or cutting with scissors
8. Has delayed language development
9. Is overly active or unable to slow down; moves quickly from one toy to another
_10. Has difficulty focusing attention or over-focuses and is unable to shift to the' next
. task
_ 11. Dislikes bathing, cuddling, or haircuts
_ 12. Overreacts to touch, taste, sounds, or odors
_ 13. Avoids playground activities
_14. Is unable to settle down; has sleep difficulties
_15. Needs more practice than other children to learn new skills

Occupational Therapy Associates - Watertown, P.e. at (617) 923-4410.
ExeclIci\lc Dir~ctor:
Jane Koomar. Ph.D .• OTRIL. FAOTA
Ctink(i~ Direccor:
Anne Trecker. MS. OTRlL,
124 Watertown St.

Watertown, MA 02472
Phone: 617-923-4410
Fax: 6 i 7-923-0468
Email: info@otawatertown.com
Occupational Therapy Associates -
Watertown, P.e.
How do I know if my school-age child has sensory

integration dysfunction?
1. Dislikes bathing, hair combing, and/ or haircuts

2. Overreacts to touch, taste, sounds, or odors
3. Avoids or does poorly in physical education or sports activities
4.. Has low muscle tone; tends to lean on arms or slump at desk
5. Needs more practice than other children to learn new skills
6. Breaks pencils frequently or writes with heavy pressure
7. Dislikes handwriting; tires quickly during written class work
8. Does not enjoy swinging or having feet of the ground
9. Has difficulty following several step instructions for motor tasks
10. Is overly active or unable to slow down
11. Reverses many letters and can't space letters on the lines
12. Has poor self-esteem; lacks confidence
_13. Finds it difficult to make friends with children of the same age; prefers to play with
adults or younger children rather than peers

Occupational Therapy Associates - Watertown, P.e. at (617) 923-4410.
Executive Director:
Jane Koomar. Ph.D .• OTRlL, FAOTA
Clinicaf Director:
Anne Trecker. MS. OTRIL.
i 24 Watertown St.
Watertown. MA 02472
Phone: 617·923·4410
Fax: 617-923·0468
tm,ii: info@otawatertowl1.com
Occupationa! Therapy Associates -

Vli'ater'wwfi, P.e.
How does an adolescent or adult know if he or she has

sensory integration dysfunction?
An individual may need to be referred for an occupational therapy evaluation if difficulties are
seen in several of these areas or if one area causes major functional problems.
_ 1. Has difficulties with balance; becomes disoriented and/or fearful on elevators or

escalators
_ 2. Fatigues easily; tends to lean on arms or slump at desk
_ 3. Is accident-prone, clumsy, or awkward in daily activities
_ 4. Dislikes crowds or accidental jostling in public situations (e.g., standing in line)
_ 5. Has low tolerance for being approached from behind or touched unexpectedly
_ 6. Has difficulty maintaining intimate relationships; dislikes physical closeness,
hugs, or cuddling
_ 7. Is disorganized in work or home activities
_ 8. Has difficulty following multiple-step instructions for motor tasks
_ 9. Has difficulty with driving (e.g., shifting gears or entering freeways) and
parking a car
_10. Has poor self-esteem; lacks confidence
_11. Has difficulty focusing attention or over-focuses and is unable to shift to the next
task

Occupational 'Therapy Associates - Watertown, P.e. at (617) 923-4410.
~
Rdationshiu BetVl'e€cll Scr~Qrv hl1.\~.gJ~ation f!1)£1 Oth.er Diagnoses
Sensory Integration Inte..D!..~ion
Educating Others
General
What is the correct diagnostic label for difficulties with sensory integration?
This is referred to as both dysfunction in sensory integration (DSI) and sensory
processing disorder (SPD). Sensory processing disorder is currently used more
commonly in the context of research, while clinicians often use the term sensory
integration dysfunction.
How do I know if my child has SI problems?
Use one of OTA Watertown's checklists to determine whether an OT or PI' sensory
integration-based evaluation might be useful. Speaking to a therapist certified in
sensory integration can also assist you in determining if problems might exist.
What are the causes of sensory integration problems?
We do not have verifiable research in this area yet, but it appears that there may be a
variety of causes, such as genetics, prematurity, birth trauma, exposure to toxins, etc.
Can sensory integration dysfunction be cured?
When occupational or physical therapy is given using a sensory integration framework,
the problems can be minimized. The nervous system can be changed, and the ability to
process sensation can be improved. Biological research has shown that with therapy,
the interference of sensory processing dysfunction with daily life tasks will be greatly
minimized.
Will sensory processing issues go away as my chUd grows up?
No, it has not been found that these issues go away with time. However, they can
appear to be minimized due to the greater flexibility most adults enjoy in choosing
daily activities in comparison to children. Adults can also receive sensory integration
intervention, and many report making gains with therapy.
Do to to.J;2
Relationship Between Sensory Integration and Other Diagnoses
How is sensory integration dysfunction related to diagnoses snch as ADHD~ ADD,

NVLD, autism, LD, etc.? If a child has another diagnosis, will be or she sml
benefit from sensory integration intervention?
Sensory integration difficulties can occur alone or can occur in conjunction with many
other diagnoses. Children with other diagnoses will likely be receiving a variety of
services (speech therapy, ABA, tutoring, etc.). They may also be using medications.
Sensory integration intervention is an appropriate service for children who, in addition
to their other difficulties, have problems with sensory processing that impact their
everyday, functional performance.
How are ADHD and ADD similar and different from sensory integration
disorder? Can ADD be cured with SI intervention?
There can be problems with arousal, attention, and excessive movement with each
disorder. Sensory integration intervention could help to reduce these problems. Some
behaviors usually attributed to ADD or ADHD may in actuality indicate sensory
integration dysfunction. For example, a child who is sensitive to touch or noise might
be easily distracted, and poor postural stability or poor processing of vestibular input
from the inner ear could result in constant movement when sitting.
Do all children with autism have sensory integration difficulties?
No, it is estimated that approximately 70% of children with autism experience sensory
integration problems, and yes, the intervention can help to reduce the devastating
effects of autism.
How is sensory processing disorder related to anxiety disorder?
Research is needed in this area, but it appears that individuals with sensory integration
dysfunction are often prone to anxiety due to the constant frustration in leading one's
life. Anxiety may also result from the tension related to being over-sensitive to touch,
taste, smell, noise, and/or movement.
Can SI intervention help children learn to talk or to read?
If the basis for the lack of speaking clearly or reading well is rooted in sensory
processing problems, then, yes, it can help develop those abilities. Many children with
speech and language problems have difficulty with cerebellar functioning. The
cerebellum is the center in the brain where vestibular (movement), ocular (visual), and
proprioceptive (body position) input is organized. Occupational and physical therapy
with a sensory integration focus can address these issues, reSUlting in improved
language skills and reading abilities. In addition, skills addressed through this therapy,
such as regulation of arousal level, postural control, and motor planning, are
foundation abilities that are needed to support learning of any kind.
Go to top
Sensory Integration Intervention
What happens during an occupational or physical therapy session where sensory

integration techniques are used?
The therapist typically structures the session using ideas and leads from the child to
make the activities as meaningful as possible. Frequently the use of an imaginative
play theme can enhance the child's willingness to engage in desired activities for
longer periods of time. The rapport that the therapist and child develop is central to the
therapy. The therapist is always working to provide the "just right challenge," while
giving the child ample opportunities for enhanced sensory input to build a stronger
foundation for skill.
What is the difference between OT and PT?
Occupational and physical therapists have very similar training, however, the OT
receives more training in oral and hand skill interventions and the PT receives more
training in postural and gross motor development.
What is the training for a sensory integration specialist? Is SI certification
necessary?
Occupational and physical therapists who specialize in sensory integration assessment
and intervention must already have a bachelor's or master's degree in their field. In
order to become certified in SI, the therapist must take four, five-day courses covering
sensory integration theory, assessment techniques, interpretation of test results, and
intervention/treatment. Some qualified therapists are not SI certified, but have had a
direct mentoring relationship with an SI certified therapist. It is ideal to be both
assessed and treated by a therapist who has this type of background and who has
experience in both evaluation and treatment of sensory integration difficulties.
What do the letters after the therapists' names mean?
The letters stand for the degree the therapist has earned and whether he or she is
registered and licensed. All therapists have to pass an examination in order to become
registered. For example, MS, OTRIL means "master of science in occupational therapy,
a registered and licensed therapist." Some therapists have FAOTA after their
credentials. This means that they have been asked to be a Fellow of the American
Occupational Therapy Association. This distinction is awarded to therapists in
recognition of their skill and knowledge, which has resulted in the growth and
improvement of occupational therapy.
How often should my child have therapy and for how long?
The length of therapy varies depending on what set of difficulties the child
experiences, but it is common for children to need 50 to 80 sessions of therapy. In
some cases therapy is given two to three times per week, which may shorten the
number of months of therapy.
What is a sensory diet? How is it different from treatment?
A sensory diet is a daily or weekly list of activities that the child can engage in during
regular routines to help maintain an optimal state of arousal. Sensory diet activities can
also provide greater body awareness prior to performing skilled tasks. Although a
sensory diet is developed by a therapist trained in sensory integration and can be an
adjunct to treatment, it can also be implemented by parents, teachers, or clients
themselves.
How is clinic therapy different from school-based therapy?
In a clinic, the goal is to provide therapy to address all aspects of a child's life (e.g.,
sleeping, eating, playing), including functioning in the home and community, as well
as at school. In the school setting, the intervention must be related to specific
difficulties in school functioning only.
Does insurance cover SI intervention? Do schools provide SI intervention?
Many insurance plans do provide coverage for occupational and physical therapy using
a sensory integration approach. Each plan is different, however, making it necessary to
talk with an insurance representative for your particular plan prior to initiating
services. Some schools will provide OT or PT with a sensory integration emphasis
within in the school setting, and occasionally a school will pay for outside services
involving sensory integration. It is most likely for a school to fund outside services if
the addition of sensory integration based intervention can help keep a child in a
regular classroom or regular education setting.
Go to top
Educating Others
How do I begin talking to the school about my child's sensory issues?

If you have an evaluation report that outlines your child's sensory issues, it is
important to share it with the school. It can also be helpful to have your child's teacher
fill out a sensory integration teacher checklist highlighting issues related to school
performance. When the teacher has made his or her own observations, it is often e~sier
to begin a dialogue. Clinics specializing in sensory integration often give informational
talks and lectures that school personnel can attend.
My special education department says SI intervention doesn't work for kids over
eight. Is this true?
No, this is absolutely not true. This myth seems to have arisen from an early study by
pioneer A. Jean Ayres, in which she compared two groups of children receiving
sensory integration based therapy. In one group the children were six to eight years of
age; in the other they were eight or older. In this study, the younger group made better
gains over a sixth month period. However, both groups made gains.
How do I educate my child's doctor and get a referral?
It can be helpful to provide your doctor with short written explanations of sensory
integration dysfunction.
My child's grandparents think my child has a behavioral or disciplinary problem.
What resources can I use to help them understand?
This is a common problem. It can be helpful to have them read books written for
laypersons, such as The Out of Sync Child by Carol Kranowitz or Sensory Integration
and the Child by A. Jean Ayres. Clinics often hold evening overviews, which can also
be informative and allow the grandparents to ask questions.
How do I explain my child's behavior to other people? For example, how do I
explain why I appear to let my child get away with so much?
It is important to tell people that your child processes sensation differently than others
do and that this difference causes your child to be constantly stressed. It can be helpful
to compare your child's reactions to the reactions we all have when undergoing a great
deal of stress. People also tend to respond well to the fact that your child has a
physiological problem and is not always in control of his or her behavior. It is also
important to recognize changes in your child's behavior during the course of therapy
and to modify your responses accordingly.
Go to top
This page last updated 2/28/06.

This website created by The Boston Web Company
Sensory Processing Disorder vs. Attention Oeficit nisorder
Carol Stock Kranowitz, M.A.
A Brief Comparison of Two II LOO}I>Alike H OisabHitics
In my book, Il.JJ.:...Qu~· Child, I define Sensory Processing Disorder (SPD) as the "inefficient neurological
processing of information received through the senses, causing problems with learning, development, and
behavior." Picture a child who has trouble processing and interpreting sensory messages about how things feel
and what it feels like to be touched. Touch stimulation overwhelms this oversensitive child.
How does his problem play out? He is bothered by the label in his tee-shirt, the approach of a classmate, the
lumps in his mashed potatoes, the stickiness of the play dough. Fidgeting and squirming, he pays a lot of
attention to avoiding these ordinary sensations. Meanwhile, he is unable to pay much attention at all to the
teacher's words or to playground rules.
Say a child with another form of SPD dysfunction has trouble processing movement and balance sensations.
Say this under-responsive child needs to move around - much more than her peers - in order to rev up and
get going. What is the fallout of her problem? This impulsive "bumper and crasher" craves intense, vigorous
movement. She often rocks, sways, twirls, jumps, climbs, leaps, gyrates and gets into upside-down positions.
She pays a lot of attention to satisfying her need for movement, and not much attention to her mother's
instructions or to where she left her shoes.
Inattention ... impulsivity ... fidgety movement ... these can be symptoms of SPD.
Now consider my definition for Attention Deficit Disorder (ADD): "a neurological syndrome characterized by
serious and persistent inattention and impulsivity. When constant, fidgety movement (hyperactivity) is an
additional characteristic. the syndrome is called Attention Deficit Disorder with Hyperactivity (ADHD)."
Inattention ... impulsivity ... fidgety movement ... these are definitely symptoms of ADD/ADHD - and of
many other difficulties, as well.
In my book, I discuss other "look-alike" conditions which share symptoms with SPD (pp. 17-20). SPD may
look like ADHD, and some symptoms may overlap. However, optimum treatment for the two problems is
different. Before jumping to conclusions and leaping to drug therapy. parents and professionals need to look at
the whole child. Then. they can thoughtfully determine what will help the most.
Shor. at Otlf aSl-lOClat~~
to lYuppmt $WD He~lflaFcj1. If the child is frequently - but not always - inattentive, it is useful to ask some questions: Where, when, and
cnck Mte 1{lF fl1(1fi:. how often does this inattention occur? What is the stimulus? What does the child do as self-therapy? What is
~~g{l!t~>i;m 8
1"',p&~iMM
happening -- or not happening - when the child concentrates well? What does the child need, and what helps?
An overloaded child needs less stimulation. So, dim the lights and tum down the radio. Comfort him with "deep
pressure" bear hugs. Help him fix up a retreat, with pillows and blankets, under the dining room table.
An under-responsive child needs more sensory stimulation. So, take her to the playground each day, jog
together around the block, engage her in gentle roughhousing, and provide her with a chinning bar, a punching
bag, and a trampoline.
SPD is a neurological problem which affects behavior and learning. Medicine doesn't fix it, but, often,
occupational therapy helps. This therapy addresses the child's underlying difficulties processing sensations
rather than just the symptoms of inattention.
Vi~tt UUI' ~p/J}th%'jf Not psychostimulants, but a good sensory diet may be a major component in treating the child with an attention
Kill!1it:!J1t!~tIj}IM,}l'tr; problem. (A sensory diet is prescribed by an occupational therapist and is rich in safe, appropriate, and
i~
enjoyable touch, pressure and movement experiences.) Taking a conservative approach can't hurt and often
helps the inattentive child whose problem is not ADD, but developmentally delayed sensory processing.
WhJ' A IlHands~OnH Sensory Diet?
Birds gotta sing, fish gotta swim, and kids gotta MOVE and TOUCH. Moving and touching are how children
first learn about the environment around them. Feeling a blanket with their skin, touching a flower petal,
stretching their arms up toward the ceiling, climbing a jungle gym, and running in great circles are ways that
children gain the important information they require to function well.
Preschoolers need a variety of active, hands-on expeliences, because kids are sensorimotor learners.
Sensorimotor means that sensory information comes in, and motor responses go out. For example, the feel of a
bunny's soft fur is a pleasant sensation, and stroking the bunny is the appropriate motor response. Children need
many concrete lessons, such as bunny-stroking, before they are developmentally ready to gather abstract
information, such as ABCs and math facts.
Using many senses leads to healthy sensory integration. Sensory integration is the neurological process of
taking in sensory information, organizing this information in the central nervous system, and using the
information to function smoothly in daily life. Sensory integration is a never-ending building process: as
children gain competence, their sensory integration improves. Thus, the more kids do, the more they can do.
Nature's educational plan is for young children to "do," by touching and being touched, and by moving and
being moved. Sensations of touch and movement come through seven sensory systems, but we think of three
basic systems when we talk about Sensory Processing Disorder:
• The tactile system provides two kinds of information: 1) The protective sense warns us to defend
ourselves from potentially dangerous touch sensations. 2) The discriminative sense tells us where we
are being touched, and about the shape, size, and texture of objects that we touch or that touch us. We
receive tactile sensations through receptors in our skin.
• The vestibular system gives us information about where our heads are in relation to solid ground; tells
us about movement, balance, and our ability to resist gravity; and organiies our bodies and brains for
effective, everyday functioning~ We receive vestibular sensations in the inner ear.
• The proprioceptive system tells us, without the use of vision, the position of our body parts and how
our bodies are moving through space. This system is very important for motor planning - the ability to
conceive of and carry out a sequence of complex movements. We receive proprioceptive sensations
through our muscles, joints, and ligaments.
At home and at preschool, children should be actively participating in hands-on, sensorimotor experiences all
through the day. Passive participation - e.g., watching others play or sitting in front of an electronic screen -
will not encourage our children to become competent and confident learners.
Some Ingredients l~'or A Hands=On, Body wOn Sensory Diet
Here are some typical sensolimotor experiences which could be selected for a "sensory diet" to help a young
child stay organized and alert for interaction and learning. Occupational therapists will recommend a sensory
diet after carefully observing your child to see what mix of calming and energizing experiences each child needs
to remain attentive and on task throughout the day.
Tactile Experiences
• Making mud pies and sand cakes

• Drawing with wet or dry chalk
• Painting sidewalks and fences with water
• Handling and pedaling tricycles
@ Walking barefoot
@ Puttering in the garden
o Playing in the sink or bathtub
III Building with blocks
@ Manipulating small objects such as Legos, dominoes and jigsaw puzzles
• Using classroom tools, such as crayons, scissors, and brushes
It Examining natural objects, such as pine-cones, feathers, sticks, and rocks
• Lying on pillows or beanbag cushions
@ Curling up in "secret hideaways"
o Petting and feeding animals
@ Finger-painting with paint, shaving cream, or chocolate pudding
• Gluing art projects
@ Manipulating play dough
@ Washing hands with soap and drying hands with towels
• Stirring cookie dough
• Eating snacks with different textures, such as cheese, pretzels, and fruit
• Handling rhythm instruments
• Dressing up
• Hugging and roughhousing gently with friends
Vestibular Experiences
• Swinging in circles on a tire swing

• Riding on a playground merry-go-round
III Swinging back and forth
III Riding up and down, walking, and balancing on a seesaw
• Jumping on a trampoline or mattress

• Jumping from a step or from the playground equipment
• Climbing a jungle gym
• Sliding down a slide
• Ascending and descending stairs
• Rolling and sledding down the hill
• Somersaulting
.. Running
GIl Walking on uneven surfaces, such as grass or sand
• Walking on a balance beam, railroad tie, or low wall

.. Crawling through tunnels or large cartons
• Swimming
Proprioceptive Experiences
GIl Pushing and pulling wagons

• Moving through an obstacle course
• Playing "bumpety-bump" on the tire swing
" Hanging from monkey bars
" Stretching up to the sky, like growing pussy wiliows
• Playing horsy
• Wheelbarrow walking
" Pouring sand, beans, water, or juice from one container to another
" Ripping paper
• Hammering nails into tree stumps or golf tees into Styrofoam
o Pressing pegs into pegboards
1& Getting in and out of seat belts, jackets and boots, shoes and socks
.. Opening doors without help
1& Tumbling on the ground
o Having a pillow fight
.. Hosing the car
GIl Walking in shoeboxes
l7~
e Walking with bag of rice or bean bag balanced on head
e Holding up the wall
• Playing catch with a ball
e Throwing sl1owb~ls at trees
.. Kneading dOllgh or meatloaf
e Pushing palms together
Visual Experiences
.. Playing flashlight tag

e Playing balloon volleyball
e Dancing with scarves
@ Tossing beanbags
@ Tracing letters/numbers on a person's back

@ Taking photos with a camera
e Blowing bubbles
@ Blowing whistles
e Sucking through straws
e Making angels-in-the-snow
• Drawing chalkboard circles, using both hands
e Playing board games
Auditory Experiences
e Dancing/moving to music
e Drawing to music
e Beating rhythm instruments
e Moving hands, feet, or whole body up and down to sound of a slide whistle
It Making up rhymes
• Singing "drop-in" songs (ex- Old MacDonald had a ~

It Humming
It Playing a kazoo
It Jumping rope and chanting
• Singing vowels while moving (for example: eeeeeeee, 00000000)

e Playing non-competitive musical chairs
For More Information

Kranowitz, Carol Stock, M.A. (1998). I!:Ji: .Q!j1::()t~SYIl(, Cbild: Re!:S!JlJli?ing and COpill!WI'irhM'I1..wlI"x
lntegrfktjon /2Y.:s.fynction.
Kranowitz, Carol Stock, M.A. (2003). 111e OU!-Q[-SWIC ChiLd Hqs Flln: ;ictiviticr.iJ..!r Kids ,-\lith Sensory
IWl!,J{tation../JJ'1ifJ1w.1if.!.!L
Wilbarger, P. (1984). Planning an adequate sensory diet: Application of sensory processing theory during the
first year oflife. Zero to Three, 5(1), 7-12.
Wilbarger, P. (1995). The. sensory diet: Activity programs based on sensory processing theory. Americall
Occupational Therapy Association Sensory Integration Special Interest Section Newsletter, 18(2), 1-3.
Williams. M. and Shellenberger, S. (1994). How does your engine run? Albuquerque, NM: TherapyWorks.
(4901 Butte Place, NW, Albuquerque, NM, 87120)
About the author:
Carol Stock Kranowitz, M.A., is a master educator who formerly taught movement and music classes in a
preschool in Washington, DC. She is the author of the best-selling book The Out-or-Sync Child: Rccogniziru.;
gild Coping with Sensory Integration Dvsfunction. Many of the activities noted above are more fully described
in The Out-of-Sync Child.
HOME
How Does Sensory Processing Disorder Affect IJearning?
Carol Stock Kranowitz, M.A.
Sensory Processing Disorder (SPD) is not classified as a learning disability, but it can certainly hamper a child's
ability to learn. To illustrate, here are stories about two preschoolers who I taught in my music and movement
room at St. Columba's Nursery School in Washington, DC.
Robin, 4, is hypersensitive to touch sensations (she avoids them). LaiTY, 3-112, is hyposensitive to movement
(he craves it). Let's look at these intelligent, healthy kids with an eye on how sensory issues are not only getting
in their way now but may also interfere with learning and behavior in the future.
Robin
Robin has Sensory Over-Responsiveness. She avoids being close to other children and shies away from adults,
too. The possibility of being accidentally touched by them makes her extremely aIlxious. She also avoids messy
play. Touching fingerpaints, mudpies, sand, play dough, glue and bubbles makes her very uncomfortable -
even threatened.
Therefore, she scoots away from her preschool classmates when it's time to sit on the rug for a story. She
refuses to participate in art projects. She resists sitting at the science table. "I hate science," she says, tuming her
back. "It's yucky." She avoids cooking and "gooking" activities in the classroom. At snack time, she becomes
upset when a drop of juice spills on her skin or even on the table.
Robin likes to dance, but not if the game is "Ring Around the Rosy," because she doesn't want to hold hands in
the circle. And not if the song is about whirling leaves, and the musical game is to hold a real leaf and twirl
around the room with it. She likes to sing, knows all the words, has a good sense of rhythm, and enjoys
chanting rhymes. But when offered rhythm instruments to accompany the song, she shoves them away. She
crosses her arms and tightens her lips.
Now, rhythm instruments aren't messy, are they? They're not slimy or sticky or smelly. But Robin refrains from
touching them, aIlyway. Unlike her curious classmates who are eager to explore objects in their environment,
she "just says no" to picking things up and examining them. She disdains putting on dress-ups, playing with
hand puppets, and drawing with crayons. Churning ice cream? Making snowballs? Picking up worms on the
sidewalk? Washing doH babies? Pouring sand from one container to another? Finger painting in shaving
cream? No way.
Shop at mu associates
to {~lJPlli'ft S~J!) tI~t:1earrJl. Robin is missing many concrete, hands-on experiences that are necessary for abstract leaming later on. She is
CliCK here for roms, also missing making connections to other children. Tactile defensiveness gets in Robin's way, physically,
socially, emotionally, and yes, cognitively, too. As she gets older, learning may become increasingly tough.
If she hasn't handled many different objects and toyed with many different textures, she may not understand
concepts such as hard and soft, wet and dry, heavy and light, prickly and smooth, sticky and slippery, fragile
and enduring. She may be mystified by challenges to estimate an object's size and shape, weight and density.
She may struggle to make sense of math, science, and art. Expressing herself in words may be limited, because
of her limited experiences and participation ill the world around her.
For the moment, her teacher is aware of Robin's tactile dysfunction and has found some ways to entice her into
the play. For example, she invites Robin to come to the art table when only one or two children are working
there, so Robin doesn't feel crowded and anxious. She offers Robin individual "finger mittens" (snipped from
latex gloves) to slip 011 her fingertips. She keeps a bucket of water nearby for Robin to rinse her hands
immediately after she touches something objectionable. She lets Robin sit at the head of the snack table, so
'U'ls!t !:ttl!' ~p{mB!:lr
'!(![}Foulld'sUmu.)f.{l other children have less chance of grazing against her.
The teacher's accommodations do help Robin - for now. But what do you guess may happen when Robin goes
to kindergarten and the great beyond? Will she be able to work in groups with other children, as expected? Will
she be competent manipulating scissors, rulers, compasses and pencils? Will she function smoothly in the big,
busy classroom?
Larry
Larry is an impetuous daredevil. He does not appear to have much sense of how to protect himself. You might
see him scrabbling up to the top rung of the jungle gym (where other kids know instinctively not to go) and
leaping to the mulch below. Bam! He lands in a heap and scrambles to his feet, covered with mUlch, grinning.
More, more, more. Larry always needs more movement experiences and needs them to be more intense than
other children's.
For instance, he craves rotary movement on the tire swing. Whereas twirling for a few minutes satisfies most
children, Larry spins hard and fast for 20 or 30 minutes. Should his teacher invite him to play Duck-Duck-
Goose or to go on a treasure hunt, he says, "No, thank you. I just want to spin." Spinning is his favorite activity.
The teacher respects his needs and lets him spin, although she worries that he's missing most of the activities
that his classmates enjoy.
Off the tire swing, Larry runs everywhere, but stopping is hard. He trips and falls often. His teacher says,
"Larry's like the Titanic. Throttles wide open, full steam ahead." He frequently bumps and crashes into his
schoolmates, pawing them to the ground for a bit of wrestling.
One day, "The Gingerbread Man" is the program dujour in my music and movement room. First, I tell the
story on the felt board. During the story, the children shake jingle bells and sing, "Run, run, as fast as you can.
You can't catch me! I'm the Gingerbread Man."
Larry is impatient: "Let's go! Let's go! Finish the story!" He doesn't want to sit; he wants to run, run, as fast as
he can. His classroom teacher gently restrains him, applying the OT technique of deep pressure. She sits behind
him, straddles her legs around him, squeezes his knees to his chest, and rocks him. The pressure and rhythmic
motion are soothing. He closes his eyes and begins to tune in. Now he sings the Gingerbread Man's theme song
along with the other kids.
Meanwhile, I conclude the felt board story and show the children how the room is set up for the "playlet." On
the bare floor, all around the rug, a large circle of masking tape indicates the "road." At one point on the road is
a red paper stop sign. The idea is for the Gingerbread Man to run once around the rug and then halt on the stop
sign. The other characters in the story will chase him, but never actually catch him.
As I point out the other props, the children watch attentively. They are so invested in the activity that they
ignore Larry, who has wriggled away from his teacher's embrace. While his classmates are learning how to
enact the story, Larry places his forehead on the rug and pivots his body around his head.
Now each child gets to choose a part to enact - the Old Woman, the Cow, the Pig, the Fox, etc. Larry jumps
up and clamors to be the Gingerbread Man. "I know this story," he says eagerly. "My Mommy reads it to me all
the time." Larry is a good listener, that I know. Even when he's twirling or rocking, he can still pay attention to
what is said or sung. But is he a good visual observer? Can he use his eyes to focus and attend? We'll see.
The playlet begins. Larry knows the story and song ... but not the significance of the red stop sign on the floor.
He wants to participate ... but can't plan and carry out how he is supposed to act and what he is supposed to
do. I repeat the information, and he says he understands ... but he still has trouble stopping. I hold his hand
and run beside him ... but he still has trouble stopping.
"Larry's doing it all wrong!" the Horse complains. "He's messing us up!"
Larry is confused and unhappy. He falls in a heap on the rug. His classroom teacher sits nearby and rubs his
back while the other children enact the story several times, until they're satisfied. Will Larry succeed in
elementary school?
SPD Resmrrces by Carol Stock Krarmwitz, M.A.
Jhe Out-of-SVllC Cl.!il.d.; Recognizing and Copi!JJ~ vvith fumsorv Integration Dv§function. (1998)
Teachers Ask Abollt Scn~)f\' Integration

Carol interviews Stacey Szklut, OTR, on audiotape
(Belle Cun'e Records, 1999)
lO I Aclivilics for Kids in Tight Spaces
About the author:
Carol Stock Kranowitz, M.A., is a master educator who formerly taught movemellt and music classes ill a
preschool in Washington, DC. She is the author of the best-selling book ~l: Recognizing
ilild Coui.n.g with Sensory Integration Dysfunction.
Page updated: 11/16/2005
The Sensory Processing Disorder Network

wv;w.SPDNctwork.org
The KID Foundation

5655 S. Yosemite Suite 305
Greenwood Village, CO 80111
What does this mean for my child?
S.pS
Sensory integration refers to the way your chiid's nervous system receives and interprets
sensory information from his body and the world around him. We are all familiar with the
five traditional senses: sight, hearing, touch, taste, ami smell. In addition to these important
senses, there ar'e two other senses, the vestibular sense and the proprioceptive sense, which
are essential in helping us register and understand incoming information.
I
The vestibular system provides information about balance and movement. When your chiid
goes down a slide, rides a swing, twirls around, and/or performs a forward roll, the vestibular
system gives continuous feedback to your child's brain. The proprioceptive system provides
the brain with information as to where the muscles and joints are positioned in relation to
the rest of the body. When your child brings a spoon to his mouth, puts his arms through
his coat sleeve, and swings a baseball bat, the proprioceptive system constantly monitors the
, L.inks
situation and provides feedback when "correction" is needed.
It is important to remember that each child's body interprets sensory information in a

different way. One child may love wild rides, enjoy spicy foods, but hates touching goopy
textures. The next child may love the deep pressure of a massage, but can't handle the
noise in a restaurant, or the smell of gasoline at the pump. Children, as do adults, interpret
sound, sight, movement, deep pressure, taste, and smells differently.
In any given moment, your child's central nervous system is focusing, screening, and interpreting
information with many senses all at once. For example, when your child is eating lunch at
school, he must use his sense of sight (as well as attention) to focus on getting the food into
his mouth. Simultaneously, he must also use his sense of hearing to filter out the
background noise to facilitate communication with a peer sitting next to him. Your child must
incorporate his sense of proprioception to gauge where his mouth is. in relation to the
position of his food and sense that his body is sitting on his chair. His sense of touch will
process the texture of his food while it is chewed. Your child's senses of smell and taste
also play an important role in this process as your child smells the aroma of the food he is
eating and connects that information with the task he receives while eating. If any of these
senses gets over~st;mulated or um:ier~stimulated in the process of the meal, the food could
end up on the floor!
If your child's central nervous system is constantly being over-stimulated or under-

stimulated, your child may be experiencing Sensory Integration Dysfunction (SID). When a
child is not processing sensory information appropriately. there may be difficulties functioning
at home, at school, or in a variety of social settings. A child with Sensory Integrative
Dysfunction may have troubles in the follOWing areas: gross motor development, fine motor
development, speech-language development, social skills, and attention. Consequently. when a
child is focused on meeting his sensory needs, it may be difficult for him to achieve his
academic, motor, and social potential.
Sensory Integrative Treatment is needed when sensory avoidant behaviors and sensory
seeking behaviors interfere with your child's functioning at home or school.
The child who is predominantly sensory avoidant is labeled as a Qshy child" or as the
Rcautious one". When a child is bombarded with too much sensory input, he may ·shut down"
and may watch his peer play instead of being an active participant. This type of child feels
the safest in his home environment, where there is greater predictability and typically
decreased sensory input. Group settings and noisy places are usually the most overwhelming
for these types of children. The noise, the lights, and the bumping against other people can
overload the child. The sensory avoidant child will typically cling to an adult to get the
security that he needs.
A child who is predominantly sensory seeking is labeled as ·wild" and "inattentive". At home
and at school, he has trouble sitting still and constantly needs to seek out all types of input.
He will often go from one activity to the next, trying to experience as much stimulation as
possible. This child may intentionally bump into his peers or often seek a tight hug. On the
playground, he is "on the go" and will often compromise his own safety. In a noisy setting,
the sensory seeking child may become even more "rowdy" and distracted.
Ai' times, is it helpful to look at each sense separately to determine whether a child is having
difficulties processing sensory information. Often a child will display sensory avoidant
behaviors in some senses while showing sensory seeking behaviors in others. The following
chart shows descriptions of behaviors often noted when children are either sensory avoidant
or sensory seeking.
Sensory Avoidant Sensory Seeking

Vestibular Spends a lot of time with "On the go"
sedentary activities
(movement) Twirls and spins self
Avoids playground equipment
Has trouble sitting still
Movement is slower than and attending
peers'
Proprioception Overreacts to getting bumped, Crashes into people and

pushed, or to falling down things
(muscle and joint
sense) Avoids getting hugged Shows decreased
safety awareness
Enjoys being in tight

spaces
Auditory Reacts negatively to loud Appears not to hear

sounds what you say
(hearing)
"Shuts down" in crowded Makes strange noises
spaces or sounds
Distracted by even smail Becomes overly

sounds energized in loud social
settings
Tactile Irritated by getting self dirty Craves sensory material

in sand, paint, play dough, etc. such as sand, water,
(touch) foam, and paint .
Overwhelmed by face and hair
washing Touches people and
things excessively
Walks on toes to avoid
textures on the feet Shows decr'eased
awareness of pain and
temperature
Oral Limits self to specific food Mouths non-food

textures and bland tastes objects
(taste)
Gags from food in mouth Craves specific tastes
in food (Le., spicy or
Eats very small pieces at a sour)
time
Over-stuffs mouth
when eating
Olfactory Overly sensitive to smells in Seeks out strange

the room smells
(smell)
Visual Enjoys being in the dark Looks intently at

objects and people
(sight) Irritated by bright lights
At SPS, Inc., our Occupational Therapists are trained in sensory integration and work with
children who are experiencing difficulty with sensory processing. By providing suspended
equipment and an array of therapeutic tools and toys, your child can seek out intensive
sensory information. The role of our Occupational Therapists is to facilitate exploration of
the various therapeutic equipment in a safe, productive, non-threatening manner. It is
through this exploration that the child's nervous system becomes more organized. Thus, your
child can become more ready to receive sensory stimulation and to process it efficiently and
accurately in his day-to-day world. Once your child is able to process his sensory
environment appropriately, he should be able to focus on and master speech-language
development, motor movement, attention issues, and social skills.
Now. .. What s the next step?

I
Your child's unique sensory needs can be determined through an evaluation process.
Individualized goals will be set for intervention based on your child's sensory profile and on
the needs specified in the family consultation. The Occupational Therapists at SPS, Inc. are
trained to target specific sensory needs and goals to help your child progress towards the
final goal of proceSSing information more accurately and being able to plan appropriate
responses. At SPS, we strive to empower children with the tools they need for a happy,
healthy life.
teast - s:m,h:.. version .gra~tll.c

version.
Copyright ® 2004 SPS-Atlanto. All rights reserved.
HOME
Home Activities for Children with Sensory Processing l)isorder
Heather Miller-Kuhaneck, MS OTRIL Bep
Jump down to:

!J:JJroc!J.1C1i(m·
1lli-'Jltporatin!l. Sensory h!J)1I1 i.nto Daily Actil'ities
f!J.!:lfx General Guidelines fqr the !:lome
Introduction
All children can benefit from appropriate sensory experiences. There is much research available demonstrating
the benefits of sensory rich environments for animals and the same appears to be true for humans. For children
who have atypical reactions to the sensory environment, the world can be a scary and challenging place.
Many aspects of home and family life may be affected when living with a child with Sensory Processing
Disorder (SPD). As a parent of a child with SPD, you know how hectic and chaotic it can be at home. Any
activity suggestions must fit easily into typical home routines or they will not be utilized. Therefore, the
following suggestions are organized around typical daily household tasks wherever possible.
Before attempting any of these activities, it is important that you understand some basic principles.
• Any activity list available on the Internet cannot possibly be individualized for a child and therefore
some activities may not be appropriate for your child.
• Some children may be over sensitive to sensations and will be fearful or withdraw from certain
activities or sensations. Other children may be sensory seeking and find many of these activities
enjoyable. You must carefully observe your child's reactions and respect them.
• A child who is indicating fear or distress should not be forced to participate. The child's fear and
discomfort is based on his or her nervous system's reaction to sensation and is real, and not under h.is
or her control.
o Many children fluctuate between sensory sensitivity and sensory seeking behaviors, and others may be
sensitive to certain sensations but seek other ones. Each child's patterns may be highly unique and
individual, and it is not uncommon for those patterns to change depending upon the context the child is
SIIOf} €II cut assooiates in (where, when, what is going on, etc.).
to SU:llll(1rt $'0 R~searctl.
CUtk hate ~or m(}r~. e Sensory seekers tend to be very active children, who are on the go. They often respond positively to
very intense forms of sensory stimu~ation and look for ways to move, jump, fall, crash, kick, push, etc.
Creating ways to incorporate these needs into safe and fun activities that provide the desired intensity
may allow your child to come to a calm and focused place. Think about ways your child can safely
push, pull, kick, hang, jump, and lift. (For example, bowling, playground monkey bars, trampolines,
pushing a "heavy bag" back and forth with you, pulling a heavy 'wagon.)
e Children who are sensitive to certain sensations (sounds, lights, smells) may like activities that provide
intense deep pressure to the skin, resistance to the muscles, and input to the joints. In general, these
inputs are calming for the system .
• Lastly, watch for signs that your child is becoming overly silly, unsafe, extremely over-active, or
inattentive. Also watch for sudden yawning, hiccoughing, burping, or changes in skin color. If you note
these things, stop the activity immediately and if necessary find something calming for your child
Vlw.itl)t:!l' SPl;}ttS@f (wrapping up in a blanket, very slow rocking, big bear hug, snuggling in a big comfy chair, warm bath
• IUn:c!f!111d~lll}lii!l<rfl or shower).
The best way to approach these activities is to present some ideas to your child and allow their preferences to
guide you. You may also find other similar ideas to add to your child's list of personal favorites.
Im::orpor2ting Sensory Input into Daily Activities
o Bath time: Scrub with washcloth or bath brush, try a variety of soaps and lotions for bathing, play on
the wall with shaving cream or bathing foam, rub body with lotion after bath time (deep massage),
sprinkle powder onto body and brush or rub into skin.
o Meal preparation or baking: Let your child mix ingredients, especially the thick ones that will really
work those muscles. Let child mix and roll dough and push flat. Allow child to help you carry pots and
pans, bowls of "Vater or ingredients (with supervision, of course). Let your child tenderize meat with the
meat mallet.
" Grocery shopping: Have your child push the heavy cart (as long as the weight is within their
capability). Let your child help carry heavy groceries and help put them away.
@ Mealtime: Encourage eating of chewy foods and drinking out of a straw. Try having your child sit on
an air cushion to allow some movement. A weighted lap blanket may be helpful as well.
o Household chores: Allow the child to help with the vacuuming or moving the furniture. Let the child
help carry the laundry basket or the detergent. Let the child help with digging for gardening or
landscaping.
@ Play time: Reading books in a rocking chair or bean-bag chair may be beneficial. You can help your
child make up obstacle courses in the house or yard using crawling, jumping, hopping, skipping,
rolling, etc. Listen to soft music. Play the sandwich game (child lies in between two pillows and
pretends to be the sandwich, while you provide pressure to the top pillow to the child's desired
amount). Ask them "harder or softer?" as you push on the pillow. Some children will like much more
pressure than you would expect. You can also go for a neighborhood walk with a wagon and have your
child pull it (make it semi -heavy by loading it with something the child would like to pull around). You
can do the same with a baby-doll carriage. Swimming in a pool is a wonderful activity if you have that
available, as are horseback riding and bowling. Mini or full-size trampolines are excellent for providing
sensory input as well. Make sure the child is using them safely. Sandboxes, or big containers of beans
or popcorn kernels can be fun play-boxes. too, if you add small cars, shovels, cups, etc.
" Errands and appointments: Before visiting the dentist or hairdresser try deep massage to the head or
scalp (if tolerated), or try having your child wear a weighted hat. Try chewy foods or vibration to the
mouth with an electric toothbrush. Let your child wear a heavy backpack (weighted to their liking with
books and with the straps padded as needed). Be sure to give the child ample warning before any
changes in routine or any unscheduled trips or errallds. Many children with SPD need predictability.
Other General Guklelines for the Home
l1li Keep routines and possessions organized.
o Be consistent with rules and consequences.
l1li Keep an activity schedule or calendar posted.
o Create specific routines for troublesome times of day (bedtime or getting ready for school).
@ Discuss upcoming anticipated changes in routine at a point in time that is beneficial for your child. You
will have to experiment with how early the child "needs to know."
• Try to indirectly use your child's sensory preferences for fun rewards to help you handle behavior. For
example, having your child work towards an extra trip to go bowling or horseback riding may be
heipful. However, try not to reSolct movement activities when your child is being disciplined. For
example, taking away recess time or playground time for not sitting at the table appropriately during
dinner may not be the most effective way to deal with these issues. Your child may need that movement
time, and by removing it, his or her behavior may actually become more difficult later.
---------------------------------
About the author:
Heather Miller-Kuhaneck currently teaches in the graduate occupational therapy program at Sacred Heart
University in Fairfield, Connecticut. She has practiced in pediatrics for years, and has specialized in school-
based practice and outpatient occupational therapy using Ayres' sensory integrative approach. She has edited a
book on occupational therapy for children with autism, and has been the quarterly editor for AOTA's School
System Special Interest Section. She is currently developing an assessment tool to examine behaviors indicative
of sensory integration dysfunction in the school setting. She can be reached at Hmilleror@vai?oo.(:orl1 or
~ckh@sacredheart.edu.
Page updated: 11/16/2005
----------_._-_.•'--------,
l;U\"\\'.SPDNetwork.org
The KlD Foundation

\\larking With the Child Who Has Sensory Integration Disorder I Scholastic.com Pagelof3
Working With the Child Who Has Sensory

Integration Disorder
By Stanley L Greenspan MD
Source: Early Childhood Today
A child who is coming into my kindergarten next year has been diagnosed with a mild form
of sensory integration disorder. What is this disorder and how can I help?
Sensory integration refers to the way people, with their individual differences, respond to
and process sensations. It also includes their ability to plan their actions (motor planning).
When there is a problem in sensory processing and motor planning, we use the term sensory
integration disorder. Sensory-processing differences and motor-planning differences have
. important influences on children's social and cognitive functioning.
Reacting to Sensations
In broad.terms, it's very useful to think of the various ways in which infants and young
children take in different sensations and plan their actions. Consider the way a particular
child responds to sensations such as sound or touch. For example, some children are
oversensitive to certain types of touch or particular sounds, while other children are
undersensitive or underreactive to such sensations. A child who is oversensitive might react
with panic or fear if someone bumps into her in pre-school. The loud hum of a busy
classroom might overwhelm an oversensitive child.
The child who is undersensitive may have a hard time responding to the teacher's voice
because it hardly registers. He may bang into things and fall down, hardly even noticing it,
because he is so underreactive to pain or touch. Children who crave sensation tend to
operate in a more daredevil fashion, banging into people, disrupting other children. They
seem to be impervious to physical sensation.
As can be well imagined, these contrasting types of children will respond very differently to
a school environment and will provide different challenges for the teacher.
Motor Planning
The ability to pLan actions, which we call motor planning, is seen in the fine-motor area
when a child is copying shapes, numbers, or letters. Some children can easily master a ten-
step pattern, while others can only follow a one- or two-step pattern and then get distracted
and need help.
Motor planning is apparent in the gross-motor area when a child is doing a complicated dance
step, standing in line, following certain rules, learning new games, or engaging in athletics.
We see wide variations in how children plan these actions. Some children are very
comfortable climbing and swinging, while others are uncomfortable, almost fearful, about
moving in space. There are others still who may want to jump from high places and seem to
want to take too much risk. This has to do with different sensitivities to movement in space.
In addition to the possibility of problems with sensation or action, these areas may not be
well integrated. In other words, they may not work together as a smoothly functioning team.
Causes and Concerns

Sometimes teachers and parents attribute these differences to emotional probleri'ls in a
child. While it can become or create an emotional problem, initially there may just be a
physical difference, originating in the central nervous system.
The way children cope with these differences depends on how well they've mastered what
http://content.scholastic.com/browse/article.jsp?id=3522&print=1 6/20/2008
Working With the Child Who Has Sensory Integration Disorder! Scholastic.com Page 2 of3
we call their functional-emotional developmental capacities (outlined in previous articles).

These include the ability to:
• attend
II engage
&\ exchange emotional gestures
II join in problem solving with others
II create ideas and use ideas logically
@ reason things out
How well a child masters these levels will in part determine how he copes. A child who has
the skills to read and is aware that she gets overwhelmed when there is too much noise can
tell the teacher, "I need some quiet time." Whereas a child who is not yet able to do that,
and expresses his feelings in actions rather than words, is more likely to hide, withdraw, or
attack when he gets overwhelmed.
At the same time, differences in sensory processing and motor planning contribute to how
well a child masters the six abilities we've described. So, for example, a child who craves
sensation may be so busy acting impulsively that she doesn't team to reason well. These
factors interrelate.
The better the environment we create-with nurturing interactions that facilitate basic
capacities for attending, engaging, communicating, and thinking-the better a child with
sensory differences will do. And the better we'll do in promoting higher levels of thinking.
Preparing the Environment:
The Overreactive Child

What educators and parents need to know is that each type of child requires a different kind
of environment. For example, the child who's overreactive to sensation and panics easily
needs a lot more soothing and regulating, slower transitions, and a great deal more
patience. We can't hurry this child. We can't put him in noisy, busy environments w~ere
he'll get overloaded and anxious. He may develop nightmares or become aggressive,
withdraw, or become overly cautious.
Having soothing and regulating environments that very gradually increase sensation is the
key to success both at school and at home. You might guide that child into a corner of the
room with one other child and, with an aide there, encourage participation in an activity.
The IJnderreactive Child

An underreactive child tends to be self-absorbed. If he's a creative underreactive chHd, he
may be engaging in pretend play on his own. That child needs to be drawn in. He needs very
energized interactions, both at school and at home.
The Sensory~Cravjng Child

The sensory-craving child, who is in everyone's business and is banging into everything,
needs a lot of structure and containment. The environment should be respectful, regulated,
and soothing. This child will need assistance in translating actions into words. It's helpful to
focus on imaginative play and building strong relationships. These children will not do well in
a school or family where relationships are fleeting, or where parents or teachers are too busy
to give them a lot of time.
When we provide appropriate environments, children with any of these differences do

wonderfully. Also, where there are a lot of these differences inchHdren, additional staff is
helpful so that care can be individualized. Remember, our goal is to get all children to the
http://content.scholastic.com/browse/article.jsp?id=3522&print=1 6/20/2008
Working With the Child Who Has Sensory Integration Disorder' Scholastic.com Page 3 of3
point where we can tum such challenges into opportunities for developing good reasoning
abilities and high levels of empathy and warmth.
RESOURCES:
The Child With Special Needs, by Stanley I. Greenspan, M.D., and Serena Wieder, Ph.D.
(Perseus Books, 1998; $32)
Stanley I. Greenspan, M.D., is coauthor, with T. Berry Brazleton, M.D., of The Irreducible
Needs of Children (Perseus Books, 2000; $24). Dr. Greenspan is a clinical professor of
psychiatry, behavioral science, and pediatrics at George Washington University Medical
School.
About the i4.uthor
Stanley I. Greenspan, M.D., is co-author, with T. Berry Brazleton, M.D., of The Irreducible
Needs of Children (perseus Press, 2000; $24). Dr. Greenspan is a clinical professor of
psychiatry, behavioral science, and pediatrics at the George Washington University Medical
School.
TM ® & © 2008-1996 Scholastic Inc. All Rights Reserved.
http://content.scholastic.comlbrowse/article.jsp?id=3522&print=1 6/20/2008 ·3 \
Tips for Tea{:bers
Kari Shanks Hall, M.A., OTR
Sensory integration is an innate neurobiological process that refers to the interpretation of sensory stimulation
from the environment (Ayres, 1979). When a child has a Sensory Processing Disorder, information from the
environment and one's own senses are not organized well in the brain. This results in problems in processing
information and behaving appropriately for the task at hand.
The following tips can help children who are oversensitive to light touch and who need movement to stay
organized in the classroom. What's wonderful about these ideas is that they work well for all children and help
them attend to and process academic information.
General Classroom Organizational Strategies

• Use graph paper to help organize math problems.
• Provide lined paper for writing assignments.
• Provide pencil grippers for children who have trouble using a mature pencil grasp.
• Remind children to use their non-dominant hand to hold the paper.
• Adjust chairs and tables to the proper height for each child. (Feet should touch the floor. Table height
should be just below the child's elbow when the fist rests under the chin.)
• Keep visual and auditory distractions to a minimum.
• If a child presses too hard on the pencil, give him a mechanical pencil.
• Always present information in the child's best modality. Visual, auditory, or multi-sensory learning
activities can facilitate understanding and memory.
Children Who are Oversensitive to Light Touch

Children who are sensitive to light, unexpected touch often prefer firm touch/pressure, which helps organ!ze
their behavior. Keep the following tips in mind:
Stil1p al DOt assot::tates
to SUJ)port SPlJftflfleal'C~l • Approach the child from the front to give a visual cue that light touch is coming.
til!4Jk. It~f~ ior ITt orB.
• Use firm pressure to the shoulder or back, rather than a gentle hand placement or a brush to the sleeve,
arm, or face.
@ Place the child's desk out of traffic, towards the periphery of the room, so that the child has a good view
of who is moving and where they are going.
e Seat a small child in an adult's lap or next to a quiet child during a group gathering. Place older
children to the side or in back of the group. Crowded places and situations can cause discomfort
because of the possibility for unexpected bumps and brushes.
• Put children "in charge" of the back of the line. The back of the line should not be viewed as a
punishment, but as a place of worth.
Vl$it tlur trif)OflllOi' Children Who Need Sensory Input to Stay on Task
• l(li}rj)Wltial1tlfUr~
Some children are "sensory seekers" and become more organized and attend better to a task if they receive
periodic movement input. Some ideas:
EI Allow a child to sit on a baffled camping pillow filled with a small amount of air. This allows for
movement without leaving the desk.
1& Suggest five minutes of swinging or climbing during recess, prior to coming back to class.
Ell Suggest some rhythmical, sustained movement (e.g., marching, washing desks, or bouncing), which can
be organizing to the central nervous system.
Ell Ask the child to erase the blackboard or run notes to other teachers, to allow him to get some extra
movement.
EI Use a rocking chair in the classroom for periodic "pick-me-ups."
® Never discipline a "sensory seeker" by taking away recess privileges or physical education - you will
intensify the random movements, fidgeting, and outbursts.
Some children also need extra sensory input to their mouths and hands in order to organize their behavior, such
as:
• Drinking from water bottles kept at desk (send them home weekly to be washed).
® Chewing on a straw, a coffee stir stick, or rubber tubing placed on the end of a pencil.
• Fiddling with something in their hands (keep a bucket or fanny pack of "squeezies" handy; a "squeezie"
is a small object that is soft and can fit in the hand, such as a balloon fined with flour, a soft ball, a dog
toy, or a koosh ball).
• Hanging by the arms on the monkey bars for 20-30 seconds at a time.
• Pushing/carrying heavy objects (e.g., carrying books, moving desks, or "pushing" against walls).
• Carrying a backpack weighted with books or bags of dried beans (this should be worn for only 15-20
minutes at a time, with an hour or two between wemings).
A reading comer with a bean bag chair makes a wonderful place to escape from too much stimulation and get
ready for more focused desk work. Children might enjoy reading or sitting under the bean bag chair more than
sitting on it.
About the author:
Kari Shanks Hall has been in private practice in Denver, Colorado, for more that a dozen years. She
specializes in working with children with Sensory Processing Disorder. She can be reached at 5290 E. Yale
Circle, Suite 207, Denver, CO, 80222, or at k.hall@oediatricot.ner.
Page updated: 1111612005

www.SPDNety,mrk.orfl,
The KID foundi:\tiQll

33
~
5/1/14
Resource List for Sensory
Family & Community Resource Center
Special School District ofSt. Louis County
12110 Clayton Road
St. Louis, MO 63131
314-989-8438/989-8108/989-8194
Answers to Questions Teachers Ask About Sensory Integration. Carol Kranowitz (2001)
An introduction to sensory challenges. Includes diagnostic checklists, progress forms, and practical tools for working with
children of all ages.
Arnie and His School Tools: Simple Sensory Solutions That Build Success. Jennifer Veenendall (2008)
Grades K-5. Introduces elementary students to basic sensory tools used to help children focus in classroom settings, such as
fidgets, chewy pencil toppers and weighted vests. (45 pages)
Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World. Brenda Smith Mylcs,
PhD (2005)
Uncovers the puzzling behaviors by children and youth with Asperger syndrome (AS) that have a sensory base and,
therefore, are often difficult to pinpoint and interpret.
Behavior Solutions for the Inclusive Classroom: A Handy Reference Guide that Explains Behaviors Associated with
Autism, Asperger's ADHD, Sensory Processing, and other Special Needs. Beth Aune, Beth Burt & Peter Gennaro
Illuminates possible causes ofthose mysterious behaviors, and more importantly, provides solutions! Teachers can quickly
look up an in-the-moment solution and learn about what the child is communicating, and why.
A Buffet of Sensory Interventions: Solutions for Middle and High School Students with Autism Spectrum Disorders.
Susan Culp (2011)
Teens. Teaches teens with autism spectrum disorders to take ownership of their sensory needs by self-advocating and self-
regulating as they transition into adulthood. (150 pages)
Building Bridges through Sensory Integration. Ellen Yack, et al (1998)

Resource book that clearly explains sensory systems and sensory integration and how to identifY problems.
Dr. Temple Grandin Speaks on Sensory Challenges & Answers (video) (1999)
Dr. Grandin speaks to her own experiences with Sensory Challenges as a person with autism.
The Goodenoughs Get In Sync. Carol Stock Kranowitz (2004)

Ages 8-12. Tale of five family members and their naughty dog (each with a different sensory processing challenge) and
how they get in sync after a tough day (89 pages)
How Does Your Engine Run? A Leader's Guide to The Alert Program for Self~Regulation. Mary Sue Williams &
Sherry Shellenberger (1996)
Describes an innovative program that supports children, teachers, parents, and therapists to choose appropriate strategies
to change or maintain states of alertness. Students learn what they can do before a spelling test or homework time to attain
an optimal state of alertness for their tasks.
It's Haircut Time: How One Little Boy Overcomes his Fear of Haircuts. Michele Griffin. (2012)
Ages 4-8. Go along with one nervous little boy, as he faces a day he DREADS - Haircut Day! This story fosters
communication, tolerance and understanding between parent and child. (36 pages)
Making It Easy: Sensor motor Activities at Home and School. Mary Haldy, et al (1999)
Resource guide deals with children preschool through elementary age who have sensor motor disorders.
5/1/14
Making Sense of Sensory Integration .. Jane Koomar, Stacy Szklut & Sharon Cermak. (audio) (2005)
Understand the differences between sensory processing disorder and "look-alike" diagnoses. Learn what to look for at
different ages and developmental stages from infancy through adulthood.
Making Sense of Art: Sensory-Based Art Activities for Children with Autism, Asperger Syndrome and Other
Pervasive Developmental Disorders. Sandra R Davalos. (1999)
Activities designed to stimulate the child s senses through manipulation and exploration, arouse curiosity and creativity,
and develop a sense of mastery.
My Sensory Book: Working Together to Explore Sensory Issues and the Big Feelings They Can Cause. Lauren H
Kerstein (2008)
A workbook for parents, professionals and children to be used at a tool to assist children in understanding their sensory
systems better.
My Service Dog: One Way a Boy Got Help with His Sensory Processing Disorder. Cindy M Jusino. (2013)
Grades K and up. This book is based on a true story of a boy that received a service dog to help with his Sensory Processing
Disorder. (26 pages)
The Out-of-Sync Child Has Fun. Carol Kranowitz (2003)

Presents activities that parents of kids with Sensory Integration Dysfunction can do at home with their child to strengthen
their child's abilities-and have some fun together along the way.
The Out-of-Sync Child: Recognizing and Coping with Sensory Integration Dysfunction. Carol Kranowitz (2006)
Identifies Sensory Processing Disorder, a common but frequently misdiagnosed problem in which the central nervous
system misinterprets messages from the senses.
The Out-of-Sync Child: Recognizing and Coping with Sensory Integration Dysfunction. Carol Kranowitz (2-part
video/85 minutes tota1/2001) (DVD/85 minutes/2009)
This guide explains how SI Dysfunction can be confused with ADD, learning disabilities, and other problems, tells how
parents can recognize the problem-and offers a drug-free treatment approach for children who need help.
A Parent's Guide to Understanding Sensory Integration. A Jean Ayres (1991)

Describes the concept of sensory integration, signs of dysfunction, the evaluation, how therapies can help and what parents
can do.
Picky, Picky Pete: A boy and His Sensory Challenges. Michelle Griffin. (2010)
Grades Pre-K and up. Children's book about a boy with sensory processing disorder. (48 pages)
Raising Kids with Sensory Processing Disorders: A Week-by-Week Guide to Solving Everyday Sensory Issues.
Rondalyn V Whitney & Varleisha D Gibbs. (2014)
Offers a compilation of unique, proven strategies parents can implement to help their children move beyond their sensory
needs and increase their performance on tasks like homework, field trips, transitions between activities, bedtime, holidays,
and interactions with friends.
Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration Issues.
Lindsey Biel & Nancy Perske (2005)
For children with sensory integration issues-those who have difficulty processing everyday sensations and exhibit unusual
behaviors such as avoiding or seeking out touch, movement, sounds, and sights-this groundbreaking book is an invaluable
resource.
Sensational Kids: Hope and Help For Children with Sensory Processing Disorder (SPD). Lucy Jane Miller (2006)
Portraits of five children illustrate the different ways in which SPD may manifest itself as well as how families cope, while
offering hope and advice to parents on how to be the best possible advocates for their children.
2
5/1/14
SenseAble Strategies: Including Diverse Learners Through Multisensory Strategies. Anne Beninghof (1998)
Grab your students' attention with noisemakers. Draw three-dimensional number lines. Apply puffY paint to workbook
pages. These and hundreds of other unique, innovative, classroom-tested strategies target diverse learning styles through
the often-underused tactile and kinesthetic modalities.
Sensory Integration and the Child. A. Jean Ayres, PhD (Thirteenth Printing - 1998)
Th is classic handbook, from the originator of sensory integration theory.
Sensory Issues in Learning & Behavior. Carol Kranowitz (video) (2009) (3 hours)
Discusses recent research in Sensory Processing Disorder (SPD), the six types of SPD and how they affect the daily lives of
children, and available treatment and therapy options. (DVD)
The S~nsory Processing Disorder Answer Book: Practical Answers to the Top 250 Questions Parents Ask. Tara
Delaney (2008)
Reference book that gives answers to most pressing questions about SPD.
Sensory Processing Disorder: Simulations and Solutions for Parents, Teachers and Therapists. (video) (2006) (25
minutes)
Kit includes DVD, small mirror, overhead magnifier, reproducible handouts, and directions on how to carry out the
simulation exercises. (DVD Kit)
The Sensory-Sensitive Child: Practical Solutions for Out-Of-Bounds Behavior. Karen A. Smith, PhD et al (2004)
Explains that the central and frequently unrecognized role that sensory processing problems play in a child's emotional and
behavioral difficulties.
Sensory Smarts: A Book for Kids with ADHD or Autism Spectrum Disorders Struggling with Sensory Integration
Problems. Kathleen A. Chara, Paul J Chara & Christian P. Chara (2004)
Ages 8 and up. We wrote "Sensory Smarts" to help people dealing with a broad range of Sensory Integration Problems.
(80 pages)
Sensory Strategies to Improve Communication, Social Skills, and Behavior. (video)

Strategies on how to handle anxiety, behavior, and sensory overload. Provides techniques for better communication.
(DVD)
This Is Gabriel Making Sense of School: A Book About Sensory Processing Disorder. Hartley Steiner (2010)
Elementary. This picture book gives teachers, parents and students a better understanding of all the seven senses, how they
are each affected at school and what kinds of accommodations are necessary to help children with SPD become learning
sensations. (28 pages)
Too Loud, Too Bright, Too Fast, Too Tight. Sharon Heller, PhD (2003)
Provides tools and therapies for alleviating and, in some cases, even eliminating sensory defensiveness.
Totally Chill, My Complete Guide to Staying Cool: A Stress Management Workbook for Kids with Social,
Emotional, or Sensory Sensitivities. Christopher Lynch, PhD. (2012)
Stress management workbook that is meant to be read, completed, and used as much as possible by children themselves. Its
fun graphics and interactive style make it ideal for children grades 3 through middle school.
Understanding Sensory Dysfunction: Learning, Development and Sensory Dysfunction in Autism Spectrum
Disorders, ADHD, LD and Bipolar Disorder. Polly Godwin Emmons et al (2005)
Understanding Sensory Dysfunction is a clear and comprehensive resource to identifYing and addressing sensory
dysfunction in children, using a range of practical strategies to help them reach their full potential at home, at school and
in the community.
3
5/1/14
Unlocking the Mysteries of Sensory Dysfunction. Elizabeth Anderson & Pauline Emmons (2004)
Tells parents and teachers what they need to know and what to do about babies who can't be comforted or toddlers who
can't communicate.
Why Does Izzy Cover Her Ears? Dealing with Sensory Overload. Jennifer Veenendall (2009)
Elementary. Offers helpful insights about sensory modulation disorders to students, parents, and educators. (39 pages)

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FAMILY & COMMUNITY RESOURCE CENTER

Tactile defensiveness is a condition in which an individual is extremely sensitive to light touch.

http://www .autism.org/si.html 6/20/2008

The Autism Research Institute distributes an infonnation packet on

What is Sensory Integration?

In addition, there are two other powerful senses:

What is Sensory Integration Dysfunction (DSI)?

Dysfunction in sensory integration is the "inability to modulate, discriminate, coordinate or organize

How efficiently we process sensory information affects our ability to:

How is 051 identified?

• Clinical observations of posture, coordination, etc.

Intervention for DSI

Intervention based on Sensory Integration Theory

• adaptations to daily routines

Traditional sensory integrative therapy

http://www .ldonline.org/article/5612?theme=print 6/20/2008 -j

The ERIC Clearinghouse on Disabilities and Gifted Education (ERIC EC)

The Council for Exceptional Children

1110 N. Glebe Rd.

Toll Free: 1.800.328.0272

Dunn, W. (1999). Sensory Profile. San Antonio: Psychological Corporation.

©2008 WETA. All Rights Reserved.

124 Watertown St.

How do I know if my infant/toddler has sensory

2. Has difficulty consoling self; is unusually fussy

For more information please call

124 Watertown St.

Oc.cupational Therapy Associates -

How do I know if my preschool child (3 to 5 years) has

1. Says III can't" or "I won't" to age-appropriate self-care or play activities

For more information please call

124 Watertown St.

How do I know if my school-age child has sensory

1. Dislikes bathing, hair combing, and/ or haircuts

For more information please call

Occupationa! Therapy Associates -

How does an adolescent or adult know if he or she has

_ 1. Has difficulties with balance; becomes disoriented and/or fearful on elevators or

For more information please call

Relationship Between Sensory Integration and Other Diagnoses

How is sensory integration dysfunction related to diagnoses snch as ADHD~ ADD,

Sensory Integration Intervention

What happens during an occupational or physical therapy session where sensory

How do I begin talking to the school about my child's sensory issues?

This page last updated 2/28/06.

A Brief Comparison of Two II LOO}I>Alike H OisabHitics

WhJ' A IlHands~OnH Sensory Diet?

Some Ingredients l~'or A Hands=On, Body wOn Sensory Diet

• Making mud pies and sand cakes

• Swinging in circles on a tire swing

III Riding up and down, walking, and balancing on a seesaw

• Jumping on a trampoline or mattress

• Walking on a balance beam, railroad tie, or low wall

GIl Pushing and pulling wagons

.. Playing flashlight tag

@ Tracing letters/numbers on a person's back

• Singing "drop-in" songs (ex- Old MacDonald had a ~

It Jumping rope and chanting

• Singing vowels while moving (for example: eeeeeeee, 00000000)

For More Information

About the author:

SPD Resmrrces by Carol Stock Krarmwitz, M.A.